Clinical analysis of 10 cases of multi-center tumor necrosis factor receptor-associated periodic syndrome / 中华儿科杂志

Objective: To summarize the clinical characteristics of tumour necrosis factor receptor-associated periodic syndrome (TRAPS) in children. Methods: The clinical manifestations, laboratory tests, genetic testing and follow-up of 10 children with TRAPS from May 2011 to May 2021 in 6 hospitals in China were retrospectively analyzed. Results: Among the 10 patients with TRAPS, including 8 boys and 2 girls. The age of onset was 2 (1, 5) years, the age of diagnosis was (8±4) years, and the time from onset to diagnosis was 3 (1, 7) years. A total of 7 types of TNFRSF1A gene variants were detected, including 5 paternal variations, 1 maternal variation and 4 de novo variations. Six children had a family history of related diseases. Clinical manifestations included recurrent fever in 10 cases, rash in 4 cases, abdominal pain in 6 cases, joint involvement in 6 cases, periorbital edema in 1 case, and myalgia in 4 cases. Two patients had hematological system involvement. The erythrocyte sedimentation rate and C-reactive protein were significantly increased in 10 cases. All patients were negative for autoantibodies. In the course of treatment, 5 cases were treated with glucocorticoids, 7 cases with immunosuppressants, and 7 cases with biological agents. Conclusions: TRAPS is clinically characterized by recurrent fever accompanied by joint, gastrointestinal, skin, and muscle involvement. Inflammatory markers are elevated, and autoantibodies are mostly negative. Treatment mainly involves glucocorticoids, immunosuppressants, and biological agents.

Improvement of high-quality evaluation criteria of Chinese patent medicines based on whole process control / 中国中药杂志

Chinese patent medicines(CPMs) are unique therapeutic drugs in China. Establishing and improving the evaluation criteria is an important measure to promote the high-quality development of CPMs. Based on the "evaluation criteria of high-grade CPMs with quality as the core index" established by our group in 2018, the "high-quality evaluation criteria for CPMs based on whole process control" was proposed in the present study in 2022. The scope of application and basic principles of the new criteria were clarified. A quality evaluation scoring table was established in the new criteria, including five parts: raw material selection, production process, quality control, efficacy evaluation, and brand building. The technical evaluation indexes involved have increased from 20% in the original criteria to 70% in the new criteria, and efficacy evaluation has been added in the new criteria. The subjective evaluation indicators account for a large proportion in the original criteria, which is prone to bias. The improved criteria overcome this shortcoming. It is expected that the new criteria as a basis can play a better role in the selection of high-quality products of CPMs, guide enterprises and institutions to participate actively in the evaluation and research of high-quality CPMs, and promote the high-quality development of CPMs.

Research progress in systemic lupus erythematosus from 2021 to 2022 / 中国当代儿科杂志

Systemic lupus erythematosus (SLE) is an autoimmune disease that affects multiple organ systems, presenting a complex and diverse clinical manifestation. The heterogeneous treatment response and prognosis of SLE pose significant challenges to its diagnosis, classification, and homogeneous treatment. The emergence of new technologies and fields, such as synthetic biology, genomics, and proteomics, has contributed to a deeper exploration of the pathogenesis and biomarkers of SLE, facilitating precision diagnosis and treatment. This review summarizes the latest research data and achievements in SLE for the years 2021-2022, providing an overview and summary of relevant studies conducted in the past two years.

Mechanism of astragaloside Ⅳ in regulating autophagy of PC12 cells under oxygen-glucose deprivation by medicating Akt/mTOR/HIF-1α pathway / 中国中药杂志

This study explored the protective effect of astragaloside Ⅳ(AS-Ⅳ) on oxygen-glucose deprivation(OGD)-induced autophagic injury in PC12 cells and its underlying mechanism. An OGD-induced autophagic injury model in vitro was established in PC12 cells. The cells were divided into a normal group, an OGD group, low-, medium-, and high-dose AS-Ⅳ groups, and a positive drug dexmedetomidine(DEX) group. Cell viability was measured using the MTT assay. Transmission electron microscopy was used to observe autophagosomes and autolysosomes, and the MDC staining method was used to assess the fluorescence intensity of autophagosomes. Western blot was conducted to determine the relative expression levels of functional proteins LC3-Ⅱ/LC3-Ⅰ, Beclin1, p-Akt/Akt, p-mTOR/mTOR, and HIF-1α. Compared with the normal group, the OGD group exhibited a significant decrease in cell viability(P<0.01), an increase in autophagosomes(P<0.01), enhanced fluorescence intensity of autophagosomes(P<0.01), up-regulated Beclin1, LC3-Ⅱ/LC3-Ⅰ, and HIF-1α(P<0.05 or P<0.01), and down-regulated p-Akt/Akt and p-mTOR/mTOR(P<0.05 or P<0.01). Compared with the OGD group, the low-and medium-dose AS-Ⅳ groups and the DEX group showed a significant increase in cell viability(P<0.01), decreased autophagosomes(P<0.01), weakened fluorescence intensity of autophagosomes(P<0.01), down-regulated Beclin1, LC3-Ⅱ/LC3-Ⅰ, and HIF-1α(P<0.05 or P<0.01), and up-regulated p-Akt/Akt and p-mTOR/mTOR(P<0.01). AS-Ⅳ at low and medium doses exerted a protective effect against OGD-induced autophagic injury in PC12 cells by activating the Akt/mTOR pathway, subsequently influencing HIF-1α. The high-dose AS-Ⅳ group did not show a statistically significant difference compared with the OGD group. This study provides a certain target reference for the prevention and treatment of OGD-induced cellular autophagic injury by AS-Ⅳ and accumulates laboratory data for the secondary development of Astragali Radix and AS-Ⅳ.

Mechanism of insulin-like growth factor 2 regulating human ovarian granulosa cell proliferation through the phosphatidylinositol 3-kinase/ protein kinase B signaling pathway / 解剖学报

Objective To explore the effect and mechanism of insulin-like growth factor 2 ( IGF2 ) on the proliferation of human ovarian granulosa cells ( KGN ). Methods KGN cells cultured in vitro and treated with different concentrations of IGF2 were divided into control group and IGF2 group (25 μg/L, 50 μg/L, 100 μg/L), and then cells were divided into control group, 100 μg/L IGF2 group, LY294002 group, and IGF2 +LY294002 group after intervened the phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway with LY294002. MTS and 5-ethynyl-2'- deoxyuridine (EdU) method was used to detect the effect of IGF2 on KGN cell proliferation, and enzyme linked immunosorbent assay was used to detect the contents of estrogen and progesterone in cell culture supernatant. The expressions of insulin like growth factor 1 receptor (IGF1R), protein kinase B (Akt), phosphorylated protein kinase B(p-Akt) and CYP19A1 protein in each group were detected by Western blotting. Results With the concentration gradient of IGF2, the proliferation rate of KGN cells and the secretion of estrogen and progesterone gradually increased. The cell proliferation rate and hormone level in the group treated with lOOfig/L IGF2 were the highest (P<0.01), while the PI3K/Akt signaling pathway was inhibited, and the cell proliferation rate and hormone secretion decreased significantly (P<0.01). The protein expression levels of IGF1R, p-Akt and CYP19A1 in different concentration groups increased significantly (P<0.05). While the expression of the above proteins were affected by intervened the PI3K/Akt signaling pathway. Compared with the control group, the protein expression of IGF1R and p-Akt increased significantly in IGF2 group and IGF2 +LY294002 group(P<0.01), CYP19A1 increased significantly in IGF2 group(P<0.01), the protein expression of p-Akt and CYP19A1 decreased significantly in LY294002 group (P<0.05), there was no significant difference in the protein expression of IGF 1R. Compared with the IGF2 group, the protein expression of p-Akt and CYP19A1 decreased in IGF2 +LY294002 group (P<0.01), there was no statistically significant difference in the protein expression of IGF1R, and the expression levels of IGF1R, p-Akt and CYP19A1 were significantly reduced in LY294002 group (P<0.01). Conclusion IGF2 may promote the proliferation and secretion of human ovarian granulosa cells through the PI3K/Akt signaling pathway mediated by IGF1R.

Endoscopic ultrasonography improving the operation effect for detecting precisely the origin and histology characteristics of esophageal leiomyoma / 解剖学报

Objective To investigate whether assessment of the tumor origin and histological features through endoscopic ultrasonography could improve the operative efficacy of endoscopic resection of esophageal leiomyoma. Methods The clinical data of patients with esophageal submucosal tumor who were treated in our department and diagnosed as leiomyoma pathologically from January 2016 to June 2020 was retrospectively analyzed. A total of 58 patients with esophageal leiomyoma underwent endoscopic resection following evaluation of endoscopic ultrasonography. The en bloc resection rate, operation time, hospitalization day, and complications were evaluated. Results Preoperative endoscopic ultrasonography showed that leiomyoma originated from muscularis mucosa in 39 cases and muscularis propria in 19 cases. The mean tumor size was 1.50 (0.2-6.5) cm, and 20 cases underwent endoscopic mucosal resection (EMR), 32 cases underwent endoscopic submucosal excavation (ESE), and 6 cases underwent submucosal tunneling endoscopic resection (STER). The overall en bloc rate was 96.6%. The mean operation time was 38.29 (15-100) min. The postoperative complication rate was 15.5% (9/58), and all were recovered after conservative treatment. Among the 39 cases originated from the muscularis mucosa, 20 cases underwent EMR and 19 cases underwent ESE. There were no significant differences in tumor size and complications between the two groups, but the operative time and the length of postoperative hospitalization in the EMR group were significantly shorter (P < 0.05). Among the 19 patients originated from the muscularis propria, 13 cases underwent ESE and 6 cases underwent STER. There were no significant differences in tumor size, operative time, the length of postoperative hospitalization and complications between the two groups. Conclusion Preoperastive endoscopic ultrasonography could precisely detect the origin and histology characteristics of esophageal leiomyoma and improves the operation effect.

Effect of Different Concentrations of Astragali Radix Containing Serum on CYP24A1，CYP27B1 mRNA and Protein in Osteogenic Differentiation of Aging Bone Marrow Mesenchymal Stem Cells / 中国实验方剂学杂志

Objective:To investigate the effects of different concentrations of Astragali Radix containing serum on the expression of 24-hydroxylase（CYP24A1），1α-OHase（CYP27B1） mRNA and protein in rat bone marrow mesenchymal stem cells （BMSCs）， and to explore the mechanism of primary osteoporosis （OP）. Method:The experiment was divided into 6 groups，like normal group， model group， low ，middle and high dose group of Astragali Radix containing serum（20%，40%，60%），Vitamin D group. Cell proliferation toxicity assay（CCK-8） was used to detect the effect of different concentrations of Astragali Radix containing serum on survival rate of aging BMSCs.Real-time quantitative PCR（Real-time PCR） and Western blot was used to detect the expression of CYP24A1 CYP27B1 mRNA and protein in senile BMSCs osteogenic differentiation cells by different concentrations of Astragali Radix containing serum. Result:Compared with normal group， the proliferation and survival rate of BMSCs osteoblasts induced by D-galactose in model group was significantly lower than that in normal group （P<0.01）. Compared with model group， medium and high dose groups and Vitamin D group could improve the proliferation and differentiation of aging BMSCs into osteoblasts in different degrees（P<0.01）. The relative expression of CYP27B1 mRNA and protein in model group was significantly lower than that in normal group， while the relative expression of CYP24A1 mRNA and protein in model group was significantly higher than that in normal group. Compared with model group， high dose Astragali Radix containing serum group could increase the relative expression of CYP27B1 mRNA and protein， and decrease the relative expression of CYP24A1 mRNA and protein in a dose-dependent manner（P<0.01）. Conclusion:The mechanism of different concentrations of Astragali Radix containing serum in the treatment of osteoporosis may be related to the regulation of CYP24A1， CYP27B1 mRNA and protein in the osteogenic differentiation of aging BMSCs.

Based on PI3K/Akt/mTOR Signaling Pathway to Explore Mechanism of Zhigancao Tang Against MIRI-induced Ventricular Tachycardia and Ventricular Fibrillation in Rats / 中国实验方剂学杂志

Objective:Through phosphatidylinositol 3-kinase（PI3K）/protein kinase B （Akt）/mammalian rapamycin target protein （mTOR） signaling pathway， explore the effect of Zhigancao Tang on myocardial ischemia-reperfusion injury（MIRI）The role and mechanism of arrhythmia（ventricular tachycardia and ventricular fibrillation）. Method:The 72 SD rats were randomly divided into sham operation group，model group， Zhigancao Tang low，medium and high dose group（11.43，22.86，45.72 g·kg-1），Wenxin granule group（2.43 g·kg-1），continuous drug intervention for 10 days. Two hours after the last administration，the MIRI model of rat was prepared by ligating the left anterior descending coronary artery，and the changes of electrocardiogram were recorded. After successful modeling，blood and heart tissue were collected to detect the content of creatine creatine（CK），lactate dehydrogenase（LDH）and aspartate aminotransferase（AST）in the serum, the enzyme-linked immunoassay（ELISA） method was used to detect cardiac troponin（CtnI）content, immunohistochemical detection of myocardial PI3K，Akt，mTOR expression. Western blot was used to detect the myocardial autophagy-related protein microtubule-associated protein 1 light chain 3（LC-3），autophagy markers Beclin1 and PI3K/Akt/mTOR signaling pathway related protein expression and phosphorylated p-PI3K，p-Akt，p-mTOR levels. Result:In model group， 100% of ventricular tachycardia and 91.67% of ventricular fibrillation occurred. Compared with sham operation group， the serum levels of CK，LDH，AST，and CtnI in the model group were significantly increased（P<0.01），PI3K，Akt，mTOR AOD values in myocardial tissue were significantly increased （P<0.01），the relative expression of the ratio of LC3-Ⅱ/LC3-Ⅰ and Beclin1 was significantly increased（P<0.01），p-PI3K/PI3K，p-Akt/Akt，and p-mTOR/mTOR were significantly reduced （P<0.01）. Compared with model group， the incidence of ventricular tachycardia and ventricular fibrillation in the high-dose Zhigancao Tang group was significantly reduced （P<0.01），and the duration was the shortest compared with other administration groups（P<0.01）， CK，LDH，AST level and CtnI content were significantly reduced（P<0.01）， the expression of PI3K，Akt and mTOR of Zhigancao Tang group was significantly decreased with increasing dose（P<0.01）， the expression of LC-3 and Beclin1 was accompanied by Zhigancao Tang increase of each dose group of soup had different degrees of decrease （P<0.01），while the expression ratio of PI3K/Akt/mTOR-related protein was significantly increased （P<0.05，P<0.01）. Conclusion:Pretreatment of Zhigancao Tang can reduce the abusually elevated cardiac enzymes CK, LDH, AST and CtnI, inhibit excessive autophagy of cells, and up-regulate the expression of PI3K, Akt and mTOR, indicating that the anti-MIRI arrhythmia effect of Zhigancao Tang may be related to the PI3K/Akt/mTOR signaling pathway.

Relationship between acute kidney injury after interventional therapy and short-term prognosis in patients with acute coronary syndrome / 医学研究生学报

ObjectivePercutaneous coronary intervention (PCI) may cause acute kidney injury (AKI) in some patients with acute coronary syndrome (ACS), leading to persistent renal dysfunction. This study aimed to investigate the relationship between acute kidney injury after PCI and short-term prognosis in patients with ACS.MethodsData of 333 patients with ACS who underwent PCI in our hospital were included. According to whether the serum creatinine level was increased above 25% during 1st to 3rd day after PCI than the preoperative, patients was divided into AKI group (n=38) and non-AKI group (n=295). Risk factors for AKI in patients with ACS after PCI were analyzed. Adverse cardiovascular events and survival rates between the two groups were compared. Univariate and multivariate analysis were performed to determine the risk factors on short-term survival after surgery.ResultsAge, diabetes, preoperative renal insufficiency, left ventricular ejection fraction (LVEF), contrast dose and count of lesion coronary artery were independent risk factors for AKI after PCI (P<0.05). Within 1 year after surgery, the total incidence of cardiovascular adverse events in the AKI group and the non-AKI group were 28.9% and 5.8%, respectively, and the difference was statistically significant(χ2=20.582, P=0.000). The patients were followed up for 2.9 to 17.2 months with a median follow up of 8.6 months. The 6-month cumulative survival rate of AKI group and non-AKI group were 94.1% and 99.6%, respectively. The 1 year cumulative survival rate was 84.2% and 96.1%, respectively. The difference in overall survival rate between the two groups was statistically significant(χ2=9.216, P=0.002). Short-term survival after PCI was associated with AKI(χ2=20.582, P=0.000), LVEF (χ2=9.055, P=0.003), count of lesion coronary artery (χ2=5.749, P=0.016) and preoperative Killip grading(χ2=4.823, P=0.028). AKI and LVEF were independent predictors of short-term survival after PCI (P<0.05).ConclusionAKI in patients with ACS after PCI has a poorer short-term prognosis, which can be used as an important factor in disease assessment and risk stratification.

Roles of regulatory small non-coding rnas in the spermatogenesis / 中国药学杂志

Non-coding RNA (ncRNA), expressed widely in organisms and comprised of a complex, regulatory and controlling biologically network, is an emerging theme in the biomedicine field at present. Regulatory sncRNAs, for example, microRNA (miRNA), endogenous small interfering RNA (siRNA) and PIWI-interacting RNA (piRNA), are the key members of the gene regulatory network and play important roles in the regulation of multiple pathophysiological activities in cells. Male infertility, a serious social problem all over the world, is mainly related the malfunctions of the spermatogenesis caused by known or unknown factors; and finally result in azoospermia, oligozoospermia or asthenospermia. Recent research indicated that regulatory sncRNAs play important roles in the development, differentiation and mature of the germ cells and their functions at different stages by silencing the transposable elements and regulating the expression of coding gene; and their abnormal expression in germ cells at different stage is closely related to male infertility. In this review, the roles and recent progresses of regulatory sncRNA focusing on piRNA to provide insight for future research in this field and for the diagnoses, interventions and treatments of male infertility are briefly summarized.

Expression of follicular helper T cells in peripheral blood of patients with hepatic echinococcosis / 中国血吸虫病防治杂志

Objective To detect the expression of follicuLar helper T cells (Tfh) and interleukin-21 (IL-21) in the peripheral blood of patients with hepatic echinococcosis and healthy controls, so as to explore the associations of Tfh and IL-21 expression with the progression of hepatic echinococcosis. Methods Fifty cases of hepatic echinococcosis and healthy controls were collected from Qinghai Provincial People's Hospital, respectively. Flow cytometry was used to detect the expression of Tfh cells in the peripheral blood of hepatic echinococcosis patients and healthy controls, and enzyme-linked immunosorbent assay (ELISA) was used to detect serum IL-21 expression in hepatic echinococcosis patients and healthy controls. The correlation between Tfh cell expression and serum IL-21 level was examined in the patients with hepatic echinococcosis. Results Flow cytometry detected a higher percentage of CD4+CXCR5+ T cells (18.49% ± 5.67% vs. 16.18% ± 4.04%, P < 0.05), CD4+CXCR5+PD-1+ T cells (4.94% ± 1.91% vs. 2.29% ± 0.79%, P < 0.05) and CD4+CXCR5+ICOS+PD-1+ T cells (30.93% ± 24.10% vs. 21.07% ± 14.25%, P < 0.05) in hepatic echinococcosis patients than in healthy controls, and no significant difference was seen in the percentage of CD4+CRCR5+ICOS+ T cells between the patients and controls (0.29% ± 0.32% vs. 0.25% ± 0.31%, P > 0.05) . The serum IL-21 level was significantly higher in the patients with hepatic echinococcosis than in healthy controls ([ 293.35 ± 2 03.65) pg/mL vs. (192.72 ± 70.09) pg/mL, P < 0.05]; however, there was no correlation between the Tfh cell expression and serum IL-21 level in patients with hepatic echinococcosis (P > 0.05). Conclusion The expression of peripheral blood Tfh cells and serum IL-21 is elevated in patients with hepatic echinococcosis, and Tfh cells and IL-21 may contribute to the progression of hepatic echinococcosis.

Expression of follicular helper T cells in peripheral blood of patients with hepatic echinococcosis / 中国血吸虫病防治杂志

Objective To detect the expression of follicuLar helper T cells (Tfh) and interleukin-21 (IL-21) in the peripheral blood of patients with hepatic echinococcosis and healthy controls, so as to explore the associations of Tfh and IL-21 expression with the progression of hepatic echinococcosis. Methods Fifty cases of hepatic echinococcosis and healthy controls were collected from Qinghai Provincial People's Hospital, respectively. Flow cytometry was used to detect the expression of Tfh cells in the peripheral blood of hepatic echinococcosis patients and healthy controls, and enzyme-linked immunosorbent assay (ELISA) was used to detect serum IL-21 expression in hepatic echinococcosis patients and healthy controls. The correlation between Tfh cell expression and serum IL-21 level was examined in the patients with hepatic echinococcosis. Results Flow cytometry detected a higher percentage of CD4+CXCR5+ T cells (18.49% ± 5.67% vs. 16.18% ± 4.04%, P < 0.05), CD4+CXCR5+PD-1+ T cells (4.94% ± 1.91% vs. 2.29% ± 0.79%, P < 0.05) and CD4+CXCR5+ICOS+PD-1+ T cells (30.93% ± 24.10% vs. 21.07% ± 14.25%, P < 0.05) in hepatic echinococcosis patients than in healthy controls, and no significant difference was seen in the percentage of CD4+CRCR5+ICOS+ T cells between the patients and controls (0.29% ± 0.32% vs. 0.25% ± 0.31%, P > 0.05) . The serum IL-21 level was significantly higher in the patients with hepatic echinococcosis than in healthy controls ([ 293.35 ± 2 03.65) pg/mL vs. (192.72 ± 70.09) pg/mL, P < 0.05]; however, there was no correlation between the Tfh cell expression and serum IL-21 level in patients with hepatic echinococcosis (P > 0.05). Conclusion The expression of peripheral blood Tfh cells and serum IL-21 is elevated in patients with hepatic echinococcosis, and Tfh cells and IL-21 may contribute to the progression of hepatic echinococcosis.

Diff erential expression analysis of microRNA gene chip in coronary particles and peripheral blood particles in patients with acute myocardial infarction with thrombus aspiration / 中国介入心脏病学杂志

Objective To investigate the diff erential expression of microRNA in microparticles from coronary blood and peripheral blood in patients with acute myocardial infarction, and to provide clues for further study on the role of myocardial in the pathogenesis of myocardial infarction. Methods Coronary and peripheral blood samples were collected from patients with acute myocardial infarction undergoing thrombus aspiration. Microparticles from coronary and peripheral blood samples were isolated by centrifugation and gene chips were used to sequence the microRNA from the microparticles in the two groups. The diff erences in microRNA expression were identifi ed between two groups and the function of these microRNA were analyzed. Results There were signifi cant diff erences between the microRNA in the microparticles from the coronary blood and peripheral blood in patients with acute myocardial infarction. By constructing expression profi les, 307 diff erentially expressed microRNA were found, with 221 of them were up regulated and 86 of them were down regulated. Conclusion There is signifi cant diff erence between the expression of microRNA in microparticles from the coronary blood and the peripheral blood of patients with acute myocardial infarction forty nine of them are closely related to cardiovascular disease, which can be used as the target of further research.

Comparison of clinical efficacy of two noninvasive respiratory support therapies for respiratory distress syndrome in very low birth weight preterm infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To compare the clinical efficacy of nasal intermittent positive pressure ventilation (NIPPV) and heated humidified high flow nasal cannula (HHHFNC) in the treatment of respiratory distress syndrome (RDS) among very low birth weight (VLBW) preterm infants.</p><p><b>METHODS</b>A total of 89 very low birth weight premature infants with respiratory distress syndrome (RDS) who were randomly administered with NIPPV (n=46) and HHHFNC (n=43) as an initial respiratory support. The incidence of initial treatment failure, the usage of pulmonary surfactant (PS), the parameters of respiratory support treatment and the incidence of complications were compared between the two groups.</p><p><b>RESULTS</b>There were no significant differences between the NIPPV and HHHFNC groups in the following items: the rate of intubation within 72 hours, rate of PS use, duration of invasive or non-invasive mechanical ventilation, duration of oxygen therapy, and incidence rates of severe apnea and pneumonia (P>0.05). There were also no significant differences in the incidence rates of bronchopulmonary dysplasia, necrotizing enterocolitis, retinopathy of prematurity, patent ductus arteriosus, intracranial hemorrhage, and air leak between the two group (P>0.05). The incidence rate of nose injury in the NIPPV group was higher than that in the HHHFNC group (P<0.05).</p><p><b>CONCLUSIONS</b>As an initial respiratory support for very low birth weight preterm infants with RDS, HHHFNC has a similar clinical effect as NIPPV, suggesting that HHHFNC is a safe and effective clinical option as a non-invasive ventilation treatment.</p>

Effect of mild hypothermia on renal ischemia/reperfusion injury after cardiopulmonary resuscitation in a swine model

Abstract Purpose: To investigate the effect of intravascular cooling on renal function after resuscitation. Methods: Twenty four pigs were randomized into three groups (n=8 in each group): therapeutic hypothermia group (TH group), normothermia group (NH group) and sham operation group (SHAM group). After 6 minutes of untreated VF, CPR was performed. Upon ROSC, the TH group received the intravascular cooling. The NH and SHAM group did not undergo therapeutic hypothermia. Haemodynamic parameters were recorded. The bloods were analyzed for serum creatinine (sCr), CysC and NGAL. The kidney was surgically removed observe pathologic changes under a light microscope. Results: The sCr increased in both TH and NH groups after ROSC, compared to baseline. Between two groups, the sCr and creatinine clearance (Cc) showed lower level in the TH group. The urine volume per hour in the TH group were higher during cooling. After resuscitation, NGAL and CysC in the NH group were higher than in the TH group. Under the light microscope, compared with the TH group, the renal injury was prominent in the NH group. Conclusion: Mild hypothermia had a protection to renal ischemia reperfusion injury after resuscitation.

Effects of hyperglycemia on the activation of microglia in focal cerebral ischemia and reperfusion / 解放军医学杂志

Objective To observe the changes of microglia in diabetic cerebral ischemia and reperfusion,and further explore the role of microglia in diabetic rats with cerebral ischemic injury.Methods Eighty healthy male SD rats were randomly divided into 4 groups:normal blood glucose sham operation group (NG sham group,n=5),diabetic hyperglycemia sham operation group (HG sham group,n=5),normal blood glucose with cerebral ischemia-reperfusion group (NG MCAO group,n=35) and diabetic hyperglycemia with cerebral ischemia-reperfusion group [HG middle cerebral artery occlusion (MCAO) group,n=35].The diabetic rats models were established by intraperitoneal injection of streptozotocin (STZ).The cerebral ischemia reperfusion models were made with MCAO,the specific marker protein Iba-1 was used to immunohistochemically label the microglia.The changes of microglia in the periventricular zone and caudate putamen region of the rats in HG MCAO group and NG MCAO group were observed at ischemia 30min and reperfusion 30min,3h,6h,Id,3d,7d and 14d (each time point contains 5 rats).Iba-1 and proliferating cell nuclear antigen (PCNA) immunofluorescence double labeling method were performed to detect the proliferation of microglia.Results After ischemia-reperfusion,the brain tissue appeared as obvious edema,mesh-like,HE staining faded,neurons swelled,cytoplasm vacuolization,nuclear pyknosis,and inflammatory cell infiltration.All these symptoms of brain injury were more obvious in HG group than in NG group.On the 3rd day after ischemia reperfusion,microglial cells were markedly activated in the infarct peripheral zone,piriform cortex and somatic sensory cortex,the activation reached the peak value at the 7th day,and the activated state continued to the 14th day of reperfusion.It was found with Iba-1 and PCNA immunofluorescence double labeling that,after cerebral ischemia-reperfusion,the increase of microglia number was related to its proliferation.The microglia proliferation also increased at the 3rd day after ischemia-reperfusion,and reached the peak value at the 7th day.The degree of microglia activation and proliferation was weaker in NG group than in HG group (P＜0.05),but higher obviously when compared with their each sham group (P＜0.05).Conclusion Hyperglycemia induced ischemia brain tissue microglia activation and proliferation inhibition may be involved in the hyperglycemia induced ischemic brain damage.

Application value of digital subtraction angiography combined with volume rendering technique in intracranial aneurysm clipping / 中国脑血管病杂志

Objective To investigate the application value of digital subtraction angiography ( DSA) combined with volume rendering technique ( VRT) in intracranial aneurysm clipping. Methods From January to July 2016,19 consecutive patients with intracranial aneurysm admitted to the Department of Neurosurgery,Northern Jiangsu People′s Hospital were enrolled retrospectively. All patients underwent craniotomy clipping immediately after clipping,DSA was performed and VRT was use to process the related images. For those with poor clipping effect, angiography was performed again after the adjustment of the aneurysm clips,until angiography confirmed that the clipping was satisfactory. Good treatment was defined as no recurrence of aneurysms and the Glasgow outcome scale of 4-5 . Results Nineteen patients had 26 aneurysms. They were all clipped completely observed under the microscope. Confirmed by angiography, 18 aneurysms were clipped completely for the first time,1 apical aneurysm of basilar artery and its contralateral posterior cerebral artery were clipped with a residual aneurysm neck,the contralateral A2 artery was clipped in 1 anterior communicating artery aneurysm, an anterior choroidal artery was clipped completetly in 1 posterior communicating aneurysm,3 aneurysms had residual necks, the upper stem artery was stenosis after 1 middle cerebral artery bifurcation aneurysm was clipped,the anterior communicating artery and the origin of contralateral A2 was stenotic after one anterior communicating artery aneurysm being clipped.Except for 2 aneurysms ruptured without adjustment during the operation,the clipping of other aneurysms was ideal after adjustment. In 2 patients with severe cerebral vasospasm,1 was relieved after a slow transcatheter injection of papaverine,1 was relieved after putting papaverine-wetted cotton piece on the site of vasospasm. The intraoperative DSA and VRT image processing time was 30-100 min. No complications associated with angiography occurred. The patients were followed up for 3-16 months,computed tomography angiography was showed no aneurysm recurrence and vascular stenosis,there were 1 case with hemiplegia and 18 cases with good recovery. Conclusions Intraoperative DSA combined with VRT can help to observe the clipping effect in real time and adjust the aneurysm clips. It can reduce the residual aneurysm neck,parent artery,and peritumoral vascular occlusion,thus improving the operation effect and reducing the disability and mortality.

Application value of digital subtraction angiography combined with volume rendering technique in intracranial aneurysm clipping / 中国脑血管病杂志

Objective To investigate the application value of digital subtraction angiography ( DSA) combined with volume rendering technique ( VRT) in intracranial aneurysm clipping. Methods From January to July 2016,19 consecutive patients with intracranial aneurysm admitted to the Department of Neurosurgery,Northern Jiangsu People′s Hospital were enrolled retrospectively. All patients underwent craniotomy clipping immediately after clipping,DSA was performed and VRT was use to process the related images. For those with poor clipping effect, angiography was performed again after the adjustment of the aneurysm clips,until angiography confirmed that the clipping was satisfactory. Good treatment was defined as no recurrence of aneurysms and the Glasgow outcome scale of 4-5 . Results Nineteen patients had 26 aneurysms. They were all clipped completely observed under the microscope. Confirmed by angiography, 18 aneurysms were clipped completely for the first time,1 apical aneurysm of basilar artery and its contralateral posterior cerebral artery were clipped with a residual aneurysm neck,the contralateral A2 artery was clipped in 1 anterior communicating artery aneurysm, an anterior choroidal artery was clipped completetly in 1 posterior communicating aneurysm,3 aneurysms had residual necks, the upper stem artery was stenosis after 1 middle cerebral artery bifurcation aneurysm was clipped,the anterior communicating artery and the origin of contralateral A2 was stenotic after one anterior communicating artery aneurysm being clipped.Except for 2 aneurysms ruptured without adjustment during the operation,the clipping of other aneurysms was ideal after adjustment. In 2 patients with severe cerebral vasospasm,1 was relieved after a slow transcatheter injection of papaverine,1 was relieved after putting papaverine-wetted cotton piece on the site of vasospasm. The intraoperative DSA and VRT image processing time was 30-100 min. No complications associated with angiography occurred. The patients were followed up for 3-16 months,computed tomography angiography was showed no aneurysm recurrence and vascular stenosis,there were 1 case with hemiplegia and 18 cases with good recovery. Conclusions Intraoperative DSA combined with VRT can help to observe the clipping effect in real time and adjust the aneurysm clips. It can reduce the residual aneurysm neck,parent artery,and peritumoral vascular occlusion,thus improving the operation effect and reducing the disability and mortality.

Protective effects of tissue factor targeting peptide on human retinal pigment epithelial cell damage induced by blue light / 中华实验眼科杂志

Background Light-induced retinal damage results in the damage of retinl pigment epithelial (RPE) cells and therefore affects the pathogenesis and development of age-related macular degeneration (AMD).Studies showed that tissue factor (TF) is overexpressed in oxidative damaged RPE cells and the choroidal neovascularization (CNV) of AMD,speculating that the suppression of TF can prevent the damage of RPE cells and inhibit CNV.Objective This study was conducted to observe the protective effects of TF targeting peptide (TFTP),a new drug of autologous synthesis,on human RPE-cells induced by blue light.Methods Human RPE cells were isolated from donor eye and cultured.Cultured cells were divided into blank control group,model group and TFTP treated group.Light-induced RPE cell damage model was established by exposuring the cells in the blue light of (4.0±-0.5) mW/cm2 for 12 hours in the model group,and different concentrations (10,100,150,200,300 μmol/L) of TF-TP were added into the medium to pretreat the cells for 24 hours and then exposed the cells to the blue light for 12 hours in the TF-TP groups.The cell viability was determined by CCK-8 assay.The morphology and ultrastructure in the cells were observed under the inverted microscope and transmission electron microscope.The apoptosis of the cells was assayed by Hoechst staining.The expressions of TF and apoptosis-related protein bax,bcl-2 in the cells were determined by Western blot.Results CCK-8 assay showed that there was no significant difference in the cell viability among blank control group and different concentrations TF-TP groups (F=2.15,P =0.11).The cell survival rate of blank control group,model group and 150 μmol/L TF-TP group was (100.0±0.00) ％,(43.79±6.55) ％ and (63.45±3.57) ％,and the survial rate was increased in the 150 μmol/L TF-TP group compared with the model group (P =0.00),and 150 μmol/L was detemined as a optimal concentration of TF-TP.A lot of shrinkage,deformation,suspension cells were exhibited under the optical microscope,and decrease of microvilli structure,rupture of mitochondrial cristae and vacuolar degeneration of the cells were found in the model group,and the damage of the cells were evidently lightened in the 150 μ mol/L TF-TP group.The apoptosis rate of the cells were (0.98 ±0.19)％,(9.98 ±0.82) ％ and (5.73 ±0.88) ％ in the blank group,model group and 150 μmol/L TF-TP group,respectively,with a significant difference among the groups (F =206.18,P =0.00),and the apoptosis rate of the cells in the 150 μmol/L TF-TP group was significantly lower than that in the model group (P＜0.05).Compared with the blank control group,the relative expression of bax and TF was obviously increased and that of bcl-2 was decreased in the model group;while the expression of bax and TF was lower,and that of bcl-2 was higher in the 150 μmol/L TF-TP group compared with the model group (all at P ＜ 0.05).Conclusions Pretreation of TF-TP can lessen cell apoptosis and increase cell survival rate and therefore plays a protective role to blue light-induced human RPE cells possibly by inhibiting bax/bcl-2 apoptotic pathways mediated by TF.

Clinical outcomes of intravascular ultrasound in guiding the treatment of non-left main intermediate coronary lesions for patients with acute coronary syndrome / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the long-term clinical outcomes of intravascular ultrasound(IVUS) in guiding the treatment of non-left main intermediate coronary lesions for patients of acute coronary syndrome (ACS).</p><p><b>METHODS</b>A total of 25 patients with intermediate coronary lesions(stenosis of 40%-70%) confirmed by coronary angiography were performed with IVUS. When MLA≥4 mm, we deferred the PCI treatment and performed optimal medical treatment (OMT). The patient were followed up for 12 month. The primary outcome was target vessel revascularization (TVR) and secondary outcome was major adverse cardiac events (MACEs).</p><p><b>RESULTS</b>A total of 25 lesions of 25 patients were examined by IVUS. 19(76%) lesions were attenuated plaque, 4(16%)were echo-lucent plaque, 2(8%) were calcified plaque. Most of the plaque (18/25, 72%) were eccentric. Positive remodeling was found in 20(80%) lesions and negative remodeling in 5(20%) lesions with meanremodeling index of 1.17=0.15. Thrombus was found in 1 case, accounting for 4%. The diameter stenosis, area stenosis, minimal lumen area and the reference diameter mea-sured by IVUS were larger than those measured by quantitative coronary angiography (all P<0.05). One patient with non-ST segment elevated myocardiac infarction was performed revascularization because MI attacked again, and 2 patients with Unstable angina were treated with OMT but they were still rehospitalization because of angina occurred repeatedly. The incidence of TVR was 4.00%, so as 16.00% of MACE.</p><p><b>CONCLUSION</b>IVUS can be used to guide the treatment of non-left main intermediate coronary lesions for patients of acute coronary syndrome.</p>